Medications: Difference between revisions

Nowadays when one is not feeling up to par he takes a few medications and with Hashem's help feels better within a couple of days and goes back to his regular routine. There are many halachic issues with regard to medications which need to be addressed. Is a beracha recited on pleasant tasting medication such as cough syrup? Does one have to recite a beracha on water when ingesting a pill? Can one walk into the bathroom with medicine? Can one take pills on [[Shabbos]]? Is it permitted to take a gel-cap? Can one take liquid medication which is full of flavors? What about vitamins? These issues will be dealt with at length in the upcoming issues.

# A beracha is not recited on food which is eaten to heal if one does not have enjoyment from the food. However, if one does have enjoyment from the food, a beracha rishona and achrona (see below) is recited.<ref>Mesechtas Berochos 38a, Tosfas Mesechtas Berochos 36a “k’von,” Meiri Mesechtas Berochos 35b, Tur 204, Shulchan Aruch 204:8, Shulchan Aruch Harav 204:14, Chesed L’alafim 204-205:5, Igros Moshe O.C. 1:82. </ref> Even if one does not want the good tasting food and is only eating it because he is ill, since he has enjoyment from it a beracha is recited.<ref>Mishna Brurah 43. </ref> Examples of medicines which require a beracha due to their pleasant taste are herbal teas and cough drops.<ref>V’sein Beracha page 200. Refer to Ateres Shlomo 8:page 110. This is the opinion and custom of Harav Pinchus Bodner Shlita (Personal telephone conversation with Harav Bodner Shlita). </ref>

# Some say even if the medicine itself does not have flavor, but is mixed with other ingredients (sweeteners) that have flavor, one still recites a beracha on the medicine.<ref>Opinion of Harav Elyashiv Shlita as expressed in Vezos Ha’beracha page 113. </ref> The reason for this opinion is because the mixture tastes pleasant and we do not look at the medicine before the taste was placed into it.<ref>Vezos Ha’beracha Birur Halacha page 310. </ref> This is the opinion of many poskim.<ref>Refer to Da’as Torah 204, Vezos Ha’beracha pages 310-311 in depth, opinion of Harav Ovadia Yosef Shlita quoted in Nishmas Avraham (English) page 89:footnote E. </ref>

# Some say if one consumes a medicine which contains sweeteners (and if not for the need of the medicine one would not consume the sweeteners, then no beracha is required.<ref>Opinion of Harav Shlomo Zalman Aurbach zt”l quoted in Vezos Ha’beracha pages 113-114, and in V’sein Beracha page 201:footnote 15.1. See explanation of this opinion in Vezos Ha’beracha page 312. Refer to Pnei Ha’shulchan page 151-152, Nishmas Avraham 1:204:page 91, Shemiras [[Shabbos]] K’hilchoso 40:footnote 191, Nishmas Avraham 1:page 90 (English), Ateres Shlomo 8:page 111. In the Halichos Shlomo [[Yom Kippur]] 5:footnote 42 it states that Harav Shlomo Zalman Aurbach zt”l retracted his previous position with regard to not reciting a beracha on sweetened medication. Refer to Vezos Ha’beracha page 356:9 notes of Harav Forst Shlita on Vezos Ha’beracha. The opinion of Harav Pinchus Bonder Shlita is that no beracha is recited on pleasant tasting cough syrup based on the pesak he heard from Harav Shlomo Zalman Aurbach zt”l (Personal telephone conversation with Harav Bodner Shlita). </ref> Others say no beracha is recited because such sweetener is only a tafel to the <br>actual medication and if no beracha is recited on the ikur, then one does not recite a beracha on the tafel.<ref>Opinion of Harav Neuwirth Shlita quoted in Nishmas [[Shabbos]] 4:204, Shemiras [[Shabbos]] K’hilchoso 40:footnote 191.  Refer to Halacha U’[[refuah]] 3:pages 282-284 in depth. However, see Mishna Brurah 174:39 and 212:1 who says the halacha is that a beracha is recited on the tafel.  See Pischei Halacha (Berochos) page 246 who disputes the claim that the reason why no beracha is recited here is because no beracha is recited on the tafel. Refer to  Rivevos Ephraim 4:54:39. </ref> Nonetheless, others disagree with this reasoning and maintain that a beracha should be recited even in this situation.<ref>Harav Yisroel Belsky Shlita, opinion of Harav Elyashiv Shlita quoted in Vezos Ha’beracha page 114, and in V’sein Beracha page 200:footnote 15, opinion of Harav Ovadia Yosef quoted in Yalkut Yosef 204:10:footnote 10, opinion of Harav Feinhandler Shlita (Avnei Yushfei in a personal e-[[mail]]).  Refer to Igros Moshe O.C. 1:82, Pischei Halacha (Berochos page 246).  Others say that it could be that Harav Elyashiv Shlita held this only in regard to medicine that is thoroughly enjoyed (Refer to Journal of Halacha and Contemporary Society 53:page 77:footnote 43).</ref> Since there is a dispute in this regard, one should recite a beracha on a different [[shehakol]] food and have in mind to exempt the medicine.<ref>Piskei Teshuvos 204:footnote 75. </ref>

# One who is forced to eat or drink something does not recite a beracha even if it tastes pleasant since he was forced to do so.<ref>Shulchan Aruch {{ibid}}, Kaf Ha’chaim 49, see Magen Avraham 20 Taz 12, Aruch Ha’shulchan 19. Refer to Mishna Brurah 204:44 who maintains if one is forced to eat bread and he is satisfied he should bentch since it is d’oraisa. </ref>

# Some poskim are of the opinion that one does not recite a beracha on a pleasant tasting medicine unless one ate a kezayis or drank a reviis of it. The reason for this is that just as one who tastes food does not recite a beracha unless a kezayis or reviis is consumed; the same applies for medications, since one does not have intent for eating.<ref>Refer to Shevet Ha’kehusi 3:84:3. </ref> Nonetheless, the poskim do not make this comparison and therefore, a beracha on pleasant tasting medicine would be required regardless of the amount being consumed since one's intent is to swallow the medicine as opposed to the "tasting" case where one does not intend to have enjoyment.<ref>Refer to Mikroei Kodesh [[Pesach]] 2:page 144, Halacha U’[[refuah]] page 278, Pischei Halacha (Berochos page 66:footnote 38), Chazzon Ovadia Berochos page 159:footnote 6.  </ref>

# The Rama<ref>204:11. Refer to Aruch Ha’shulchan 22. </ref> says any food which a healthy person does not eat requires a [[shehakol]] if taken as medication, regardless of the food's real beracha.<ref>Aruch Ha’shulchan 22. Refer to Mishna Brurah 54. The Shar Ha’tzyion 45 says this applies to medicine which was made from the five grains as well. Refer to Halacha U’[[refuah]] 3:page 284. </ref> Others say one should recite the appropriate beracha.<ref>Magen Avraham 24, Mishna Brurah 55, Igros Moshe O.C. 1:82. </ref> The Mishna Brurah<ref>212:4-5. </ref> maintains that one should avoid this situation when possible.<ref>Some say one should eat the other food before the medicine and then consume the medicine (Halacha U’[[refuah]] 3:page 284). </ref>

# For years people have been erroneously consuming Listerine Pocketpaks® without a hechsher, but obviously this product needs a hechsher,<ref>See www.koltorah.org quoting the opinion of Rabbi Chaim Jachter Shlita. </ref> especially since it is digested in the stomach.<ref>Opinion of Harav Yisroel Belsky as expressed in OU document I-98:page 2. </ref> Recently, this product became available with a hechsher. The question arises if this product requires a beracha prior to placing it in one's mouth. Many people do not recite a beracha. However, even though this product melts in the mouth, it is swallowed and therefore, according to some poskim a beracha of [[shehakol]] should be recited before placing it in the mouth.<ref>Harav Yisroel Belsky Shlita, opinion of Harav Forscheimer Shlita (personal telephone conversation), and Harav Doniel Neustadt Shlita.    </ref> Others maintain that a beracha does not need to be recited.<ref>Opinion of Harav Pinchus Bodner Shlita, Harav Ephraim Greenblatt Shlita (Personal telephone conversations). Harav Forst Shlita says if one is taking it for flavor then a beracha is recited, but if it is for fresh breath but not for the flavor in the mouth then no beracha is recited. The opinions of Rabbi Wikler Shlita, Harav Felder Shlita, Harav Fuerst Shlita (personal telephone conversations with the aforementioned rabbonim). This is the opinion of Harav Yisroel Reisman Shlita (as related by Rabbi Shimon Newmark). </ref>

# The company says that there is nothing unsafe with swallowing it since there is no alcohol in the product.<ref>Based on a conversation with Lisa at the Johnson and Johnson Company. </ref> If one uses a breath mist (with a hechsher) then one does not recite a beracha on it, instead one should make a [[shehakol]] on a different food.<ref>Harav Yisroel Belsky Shlita.</ref>

# If there is no flavor on the coating on a pill, no beracha is recited because there is no enjoyment from the pill. In addition, swallowing medication without chewing it first is not the normal manner of consumption and is not viewed halachically as eating. Furthermore, it is possible that these pills are not fit to be eaten<ref>Refer to Mesechtas Avodah Zarah 67-68, Mesechtas Pesachim 21b and 45b. In addition see Shulchan Aruch Y.D. 103, and Y.D. 155:3. </ref> and therefore do not require a beracha.<ref>Shulchan Aruch 202:2, see Chazzon Ovadia Berochos page 158, Piskei Teshuvos 204:18:footnote 70. </ref> Some say this even applies to a pill which has a sweet coating; since one swallows it no beracha is recited.<ref>Vezos Ha’beracha page 311, Piskei Teshuvos 204:18, see Nishmas Avraham 4:204:footnote 1. In regard to vitamins, refer to Pischei Halacha (Berochos) page 68:footnote 39 alef, Beracha Achrona (Boreh Nefoshos) page 201. Refer to Nishmas Avraham (English) pages 89-90 quoting the opinion of Harav Shlomo Zalman Aurbach zt”l that a beracha is required. See Ateres Shlomo 8:page 111. The same applies to vitamins (Yalkut Yosef 3:page 436). </ref>

# Some say if one is taking a pill in order for one to lose weight and by taking the pill it makes one feel full, then one should recite a beracha on the pill since it is instead of food. Nonetheless, the poskim suggest one makes a beracha on something else instead.<ref>Piskei Teshuvos 204:footnote 70. </ref>

# A chewable pill which has a pleasant taste requires a beracha according to those who recite a beracha on pleasant tasting medications.<ref>Piskei Teshuvos 204:18:footnote 74. </ref> One should recite a [[shehakol]] on a different food before consuming flavored Tums® that have a hechsher.<ref>Harav Yisroel Belsky Shlita. The Diamond – K hechsher on Tums may be relied upon (Harav Yisroel Belsky Shlita). One may not use Tums on [[Pesach]] if they are not certified for [[Pesach]] (Harav Yisroel Belsky Shlita). </ref>

# One who receives food in a liquid form through intravenous does not recite a beracha on the food.<ref>Tzitz Eliezer 13:35:3, Vezos Ha’beracha page 113 quoting the opinion of Harav Elyashiv Shlita.  </ref>

Many times before a medical procedure is performed one is given something to drink. This drink does not necessarily taste good on its own, but sweeteners are added to it. The status of whether a beracha would be recited is dependent on the both opinions mentioned above.<ref>Refer to Journal of Halacha and Contemporary Society 53:page 74:footnote 36. </ref> One who is given something to eat before a procedure would recite a beracha on the food.<ref>Nishmas Avraham 4:204:pages 7-8 quoting the opinion of Harav Shlomo Zalman Aurbach zt”l. </ref>

# When one is taking a pill that does not taste pleasant and wants to drink water to mask the bad taste, no beracha is recited on the water.<ref>Aruch Ha’shulchan 204:18, Pnei Ha’shulchan page 146, Piskei Teshuvos 204:footnote 64, Binyan Sholom (old print) page 96, Ateres Shlomo 8:page 111.  Refer to Sheilas Rav 2:18:5. If one places water in liquid medicine to make it taste better no beracha is recited on the water (Sharei Ha’beracha 18:footnote 76). If one needs to drink water for medical purposes and he is not thirsty he should recite a beracha on something else and have in mind to exempt the water from a beracha (Harav Yisroel Belsky Shlita, see Eishel Avraham Butchatch 204:7). </ref> The same is true if one is taking a pill and is not thirsty.<ref>Ben Ish Chai Mattos 1:12, Aruch Ha’shulchan 204:18, Miyum Ha’halacha 22, Rivevos Ephraim 6:76, Pischei Halacha Berochos 4:8, Oz Nedberu 10:22. Harav Shlomo Zalman Aurbach zt”l maintains one may drink more water than needed for a pill and a beracha would not be required on that water either (Ve’aleihu Lo Yeibol 1:pages 110-111). </ref>  

# Before a woman goes for an ultra sound/sonogram she is asked to drink water. No beracha is recited on the water.<ref>Refer to Yufei Leleiv 204:10, Sdei Chemed Berochos 33:page 260, Me’am Loez Yisro 247:page 580, Pnei Ha’shulchan page 146, Sharei Ha’beracha 18:footnote 76. </ref> It would seem that a nursing woman, who needs to drink a lot of water, would not recite a beracha on the water if she is not thirsty.<ref>Refer to Toras Hayoledes 62:3,  Beracha Achrona page 196:5.</ref> However, others maintain that she should take food whose beracha is [[shehakol]] and exempt the beracha on the water.<ref>Toras Hayoledes {{ibid}}. </ref>  

# Many times, after one brushes his teeth or rinses with mouthwash, he drinks water to rinse out his mouth, one does not recite a beracha on such water.<ref>Sharei Ha’beracha 18:footnote 76.</ref>

# If one has a sore throat and drinks water to clear his throat, it would seem that a beracha is not recited.<ref>Harav Yisroel Belsky Shlita.</ref> (In all the above situations, if one is thirsty, a beracha is recited). One who drinks a tasty beverage to take his pill would recite a beracha on the beverage.<ref>Chesed L’alafim 204-205:4, Mishna Brurah 204:42, Ateres Shlomo 8:page 111, Yalkut Yosef 204:page 436.  </ref>

# It is very common to take a powdered medicine and mix it with a food or water. Some may say that since the food which the medicine is mixed into is a tafel, no beracha is recited. Nonetheless, others say one should recite a beracha on the mixture.<ref>Refer to Journal of Halacha and Contemporary Society 53:pages 78-79. </ref> If the food (not medicine) is not a [[shehakol]],<ref>For example chunky applesauce. </ref> the Rama<ref>212:1. </ref> holds the beracha is a [[shehakol]] regardless of the beracha of the food, while others argue with this ruling.<ref>Refer to Magen Avraham 4, Gr’a,  Mishna Brurah 4-5, 10, see Taz 7. Refer to Halacha U’[[refuah]] 3:page 284. </ref> The Mishna Brurah<ref>212:4-5. </ref> maintains that one should avoid this situation when possible.<ref>Some say one should eat the other food before the medicine and then consume the medicine (Halacha U’[[refuah]] 3:page 284). </ref>

# When one consumes a medicine during a meal a separate beracha is required since the medicine is not part of the meal.<ref>Shevet Ha’kehusi 3:78. </ref>

# Since there is ruach ra'ah under a bed one should not store food under a bed.<ref>Shulchan Aruch Y.D. 116:5. </ref> However, one is allowed to store medicine under a bed and there is no concern of ruach ra'ah.<ref>Tzitz Eliezer 17:32. Some say if it is a medication which one recites a beracha on because of its pleasant taste then it should not be placed under a bed (Shevet Ha’kehusi 2:245, see 3:229:2). </ref>

# It is permitted for one to walk into the bathroom with a pill etc.<ref>Be’er Moshe 8:41. </ref> In addition it is permitted to keep medicines in a medicine cabinet that is in the bathroom,<ref>Rivevos Ephraim 1:8:2, 2:6, Teshuvos V’hanhugos 1:11, Be’er Moshe 8:41. </ref> but one should not take his medicine with water in a bathroom.